Oral Isotretinoin
Oral isotretinoin suppresses sebum secretion, inhibits cell
proliferation, inhibits bacterial proliferation, controls the formation
of microcomedones, normalizes keratinization and reduces the formation
of lesions and comedones, and it may have anti-infammatory effect (44,
45). In patients whose acne is severe and refractory to oral
antibiotics, COCs, and spironolactone, isotretinoin use should be
considered (42). Isotretinoin treatment may be beneficial in patients
with severe cystic acne who are not able of using COCs (46).